Implementation of a breast and cervical cancer screening program in a public hospital emergency department Journal Article


Authors: Mandelblatt, J.; Freeman, H.; Winczewski, D.; Cagney, K.; Williams, S.; Trowers, R.; Tang, J.; Kerner, J.; Cancer Control Center of Harlem
Article Title: Implementation of a breast and cervical cancer screening program in a public hospital emergency department
Abstract: Study objective: To assess the feasibility and yields of screening for breast and cervical cancer in an urban public hospital emergency department. Methods: Women who presented to the ED of a large, urban public hospital during the study period with nonurgent conditions were eligible for a Papanicolaou test (Pap smear) and a clinical breast examination (CBE) if they were 18 years of age or older, and for a mammogram if they were 40 years of age or older, provided they had not had the screening examination within the past year. The Pap smear and CBE were performed by a nurse, and mammography was scheduled for a later date. Women with gynecologic complaints were excluded. Results: On the basis of screening history, medical status, and age, 1,850 (32%) of the 5,830 women seen in the ER during the 23-month study period were eligible for both mammography and CBE, and 2,361 (41%) were eligible for Pap smears. Of these women, 116 (6%) completed mammography and CBE, and 644 (27%) received Pap smears. Among screened women, 10 (9%) and 20 (3%), respectively, had results that were suspicious or positive for breast or cervical cancer. Follow-up rates were low: 20% for breast screening and 50% for Pap smears. Among those receiving follow-up, 1 woman was found to have breast cancer and 8 were found to have cervical neoplasia. Conclusion: ED cancer screening was feasible and yielded a high rate of cancer detection. Program efficiency was hampered by low volume and high numbers of patients lost to follow-up after abnormal screening results. Greater integration into the acute care setting and more intensive recruitment and follow-up strategies are needed to maximize the potential yield and cost-effectiveness of such programs.
Keywords: survival; randomized controlled trial; follow-up; intervention; primary-care; health-care; referrals; social-class; poor black-women; room
Journal Title: Annals of Emergency Medicine
Volume: 28
Issue: 5
ISSN: 0196-0644
Publisher: Mosby, Inc  
Date Published: 1996-11-01
Start Page: 493
End Page: 498
Language: English
ACCESSION: WOS:A1996VQ47600005
DOI: 10.1016/s0196-0644(96)70111-7
PROVIDER: wos
PUBMED: 8909269
Notes: Article -- Source: Wos
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